Dr. Lawrence Loh, Acting Medical Officer of Health, advised that the virus that causes COVID-19 relies on person to person interactions to spread, which is why contact tracing is so important. The Region of Peel’s contact tracing teams have tracked down the contacts of every reported case since the first case was identified in our jurisdiction. Person to person spread also relates to why physical distancing measures are recommended and why those must stay in place in the short term. Physical distancing is the plan when there is a total susceptible population, faced with a disease that masquerades as mild and spreads easily from person to person, with severe results for the elderly and the unwell, and sometimes seemingly at random. Distancing limits interactions and slows spread, and makes it easier to contact trace.
Dr. Loh stated that the pace of community cases is starting to slow thanks to the measures implemented in late March; however, hospitals continue to see increasing numbers of hospitalizations, Intensive Care Unit admissions and deaths from COVID-19 complications. There is spread and severity in various congregate settings across the community, specifically in seniors’ homes. Peel Public Health has moved into an expanded response to support senior settings in coordination with hospital and healthcare partners with respect to screening, outbreak control and workforce.
Monali Varia, Manager, Infection Prevention and Surveillance, presented the epidemiologic profile of COVID-19 cases in the Region of Peel and explained how modelling can look at the potential impact of interventions. She presented various modelled scenarios for the Region of Peel that compared base case versus enhanced testing and some physical distancing applied over one month, six months and dynamic measures over 18 months.
Monali Varia stated that measures such as physical distancing, isolating cases and management of contacts are effective and need to continue in order to flatten the curve overall, which avoids burden on the health system and ensures everyone who needs to be hospitalized gets care; and, delay the peak to buy time for effective treatment and development of a vaccine.
In response to a question from Councillor Saito, Dr. Loh stated that when determining whether to issue Orders versus recommendations, such as for physical distancing, the Provincial or Regional Medical Officers of Health must consider the challenges associated with enforcing the orders.
In response to questions from Councillor Brown, Dr. Loh advised that the support being provided by Canadian Forces personnel at long term care homes is focused on supporting non-personal work so that staff can focus on resident care.
Monali Varia noted that the number of outbreaks and resident cases at long term care homes would be included on the Region of Peel dashboard.
The Acting Commissioner of Health Services undertook to request information from the Integrated Response Table with respect to the needs of long term care homes in the Region of Peel related to infection prevention and personal protective equipment.
Councillor Sinclair requested clarification regarding Slide 14 which depicts modelled daily new cases in Peel over the next 18 months. He raised concern that public health measures such as physical distancing and hygiene practices are extended in two to four week increments, which leads to public misconception that COVID-19 management may be relaxed during the summer months.
Monali Varia responded that this model is a tool showing an example of what could happen and does not use current data; using the dynamic measures allows for the maintenance of the health system capacity.
Dr. Loh stated that conversations are occurring between the Province and Public Health services regarding balancing out the interventions. The question of how and when a gradual restart of services and businesses can occur, will be dependent on data, such as a threshold of the number of deaths or Intensive Care Unit admissions. He noted that the model does not take into account the development of a vaccine or a cure, which would alter the trajectory of the interventions available, however it typically takes 1 to 1.5 years to develop a vaccine.
In response to a question from Councillor Ras, Dr. Loh noted that it is hoped that a vaccine will be developed for COVID-19 and it would be recommended that people receive it in addition to the flu vaccine as the flu is caused by a different family of viruses.